However, many fail, and even successful ones may lack the consistent funding needed for proper implementation. School-based sex education programs, especially those meeting specified process and content standards, have been found to reduce sexual risky behavior. The main sources of sexual education for adolescents are school, parents, friends and the media, especially the Internet. The next section reviews this record, with particular attention to the challenges of replicating even seemingly successful programs in wide-scale dissemination, outside the controlled conditions of clinical trials. From the variety of approaches that have been tried, certain characteristics of interventions have been identified as being especially effective. Īs a result of such complications, sexual health has proven a particularly stubborn problem, compared to other health behaviors. Perhaps in anticipation, women tend to be indirect about condoms, with many young women unable to discuss the topic at all, even when they would prefer to use one. For example, male partners most resistant to condom use are also those most likely to react angrily to female partners’ proposals of condom use. No single strategy appears to be best, as different strategies work better with different partners, and reactions to communication attempts can vary widely. Even when they are inclined to ask, young women who have fewer communication strategies at their disposal are less likely to convince their partner to use a condom. They may feel too little control over sexual situations to ask partners about condoms, especially when those partners are older or give them monetary or other valuable gifts. Įven those less intrusive behavioral changes face significant barriers, especially for young women. In particular, they might encourage greater condom use, a relatively effective means of preventing sexually transmitted infections and unwanted pregnancies. Interventions might focus on the daunting challenge of preventing sexual behavior itself, or might set a more modest goal of changing aspects of behavior associated with higher risk.
will spend over $15 billion on lifetime medical care to treat the sexually transmitted infections contracted in a single year, meaning that even fairly intensive prevention efforts have the potential to be cost-effective. Although non-viral infections can be cured once diagnosed, many are a symptomatic in their early phases and others, perhaps most notably HIV, have no cure. Human papilloma virus plays a role in the development of most cervical cancers as well as other genital cancers and cancers in the mouth and throat, with rising rates of the last due in part to the increasing practice of oral sex in younger populations. Chlamydia trachomatis and Neisseria gonorrhea can cause pelvic inflammatory disease (PID), resulting in chronic pelvic pain, ectopic pregnancy, and infertility, and also increase susceptibility to HIV. These infections cause significant morbidity, extending beyond the adolescent period when they were first contracted.
Young women are at especially high risk, due to age-related physiological vulnerability, limited knowledge, inadequate condom use and frequent condom failures. In the US, adolescents and young adults (15–24 years) account for nearly two-thirds of new chlamydia infections and 70% of new gonorrhea infections. These goals require particular focus on adolescents. Healthy People 2020 objectives, citing the United Nations Report on Population and Development, identify prevention of sexually transmitted infections as part of essential primary care for improving reproductive health. An early version of the intervention was further refined using results from a pilot evaluation, resulting in an award-winning interactive video intervention that can hold adolescents’ attention while delivering critical content on sexual health at extremely low cost to broad populations.
This paper reviews the development and effectiveness of an intervention aimed at reducing adolescents’ risky sexual behavior, detailing its foundation in behavioral decision science research methods. Avoiding or ameliorating a health-related problem is usually medically and ethically superior to treatment and is often financially advantageous. Prevention is the hallmark of public health research and practice.
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